Prevalence and risk factors for alcohol use among fifth and sixth grade children in Puerto Rico, 2005-07

Underage drinking is a major public health problem in Puerto Rico. Almost 25% of adolescent drinkers report beginning before age 12, but most prevention efforts are targeted to teens. Alcohol use and its risk factors among children is rarely discussed. "Consulta Juvenil VII", a cross-sectional survey conducted in 2005-07, is the only study in PR that estimates the prevalence and evaluates risk factors for alcohol use in a nationally representative sample of elementary school students (5th-6th grade). The sample (n=1,708) was selected using a multi-stage stratified cluster sampling design. Multiple logistic regression models were used to evaluate the association between alcohol use and socio-demographic, individual, peers, school, family, and community characteristics. Collinearity was assessed before multiple regression models. Prevalence of alcohol use was 34.6% (95% CI=30.7-38.5%). Smoking, ever been offered illicit drugs, and having friends who drink were the most important predictors of alcohol use among students. Other risk factors included: damaging property, forgetting planned tasks, antisocial behavior, good/excellent health, none/little perceived risk in 1-2 daily drinks, and having siblings or parents that drink. Our findings seem to suggest that risk factors for pre-adolescents' alcohol use are different from those identified among PR adolescents. There also seem to be cultural differences. Unlike other populations, peer factors appear to be more influential in a PR child's alcohol use than family factors. These results provide important baseline information and a better understanding of alcohol use by elementary school students that should be considered when designing and implementing prevention programs for our pre-adolescents.